"Employers provide the majority of health insurance benefits in this country. They must have a seat at the health reform policy table."

These were the first words of advice for Michigan business owners from Rick Lord, President of Associated Industries of Massachusetts (AIM) and Michael Widmer, President of the Massachusetts Taxpayers Foundation. They represented two of the four employer organizations that worked with their state legislature to help pass universal health care coverage in 2006 for the state's 6.5 million residents.

These business leaders believe that having businesses involved in health reform policy in Massachusetts has resulted in a balanced and sustainable approach to health reform and with a much better outcome than if they had not been involved.

Here are some of their insights and words of advice on how Michigan business leaders can play a role in shaping health reform policy in our state.

1. BUSINESS LEADERS MUST SHARE A COMMON GOAL.

The Massachusetts businesses believed universal coverage was needed because they were going to pay for the uninsured one way or another, through uncompensated care assessments, cost shifting, high premiums or a less healthy workforce. The road to balanced policy was not easy, but a common goal and purpose allowed them to work through their obstacles.

2. COLLABORATION AND COMPROMISE ARE KEY TO POLICY REFORM.

Along the way, a number of proposals emerged that the business community opposed, but their representatives stayed at the table to work through the issues. For example, business leaders were able to develop a compromise over a proposed payroll tax by requiring a minimum level of employee coverage or else pay an annual employee assessment of up to $295 to help fund uncompensated care. The principle behind the compromise was that all employers should share equal responsibility for the costs of health care provided to uninsured residents.

3. THE INDIVIDUAL MANDATE DID NOT UNDERMINE EMPLOYER-SPONSORED HEALTH COVERAGE.

Despite some predictions that employers would send more of their employees to the state's insurance exchange, more agreed to offer coverage because they realized that, to remain competitive, they needed to offer health benefits. The process of working together on reform policy also helped them realize the program would work best with the shared support of businesses, individuals and the government.

4. THE BUSINESS COMMUNITY HAS AN IMPORTANT ROLE TO PLAY IN INFORMING AND EDUCATING EMPLOYERS AND THE GENERAL PUBLIC ABOUT THE BENEFITS AND REQUIREMENTS OF HEALTH CARE REFORM.

One of the results of universal coverage was to help businesses become better purchasers of health care coverage. AIM sponsored workshops, webinars and developed a guidebook to educate the employers and employees in their organization about the law's policies and regulations. Businesses were also featured that found innovative ways to improve the quality of care, implement health and wellness programs for their employees and manage costs.

5. COST CONTAINMENT IS VITAL TO REFORM BECAUSE UNIVERSAL COVERAGE WILL BE INEFFECTIVE IF HEALTH COVERAGE IS NOT AFFORDABLE.

Rob Fowler, president of the Michigan Small Business Association who spoke at this event, indicated that the cost of health care coverage is one of the biggest concerns for businesses and can keep them from being competitive. The Michigan SBA has endorsed the Medicaid expansion in our state because it will expand the pool of dollars available for care and help reduce the burden on employers who have been helping to carry the cost of uncompensated care.

Massachusetts has moved cost containment to the top of their agenda and have implemented three different laws in the past four years to regulate how much hospitals and health plans can raise their rates. They are seeing a shift to employers offering more high deductible plans and health insurance companies offering tiered network plans. Hospital and physician providers are also working together with insurance plans to manage costs. And the state has implemented a $60M wellness fund to encourage healthy lifestyles and provide tax incentives to companies that use wellness programs.

Based on the lesson from Massachusetts, Michigan businesses have a strong role to play in shaping and influencing health reform policy in our state. Or in the words of Rob Fowler, "If you are not at the table, you're on the menu."

You can watch the entire event below. re:group sponsored the live streaming of the symposium: